Lung cancer micro-costing: economic impact based on real-world evidence

Abstract

ABSTRACT Objective: To assess the economic impact of patients diagnosed with lung cancer using micro-cos ting based on real-world data from a reference Brazilian public institution. Methods: A retrospective, descriptive, and analytical study of lung cancer patients enrolled between March and August 2017 at the National Cancer Institute was conducted. Bottom-up micro-costing was applied to estimate direct costs, mapping the entire patient journey up to five years of follow-up or death. Costs were obtai ned from official databases, such as the Health Price Database and the Procedures Table Management System of the Unified Health System. Results: Of the 161 participants initially selected, 81 were exclu ded due to death before histopathological diagnosis. Of the 80 patients included, 92.5% had non-small cell lung cancer and 54.1% were smokers or ex-smokers. Median overall survival was 6.9 months (95% CI: 5.00-12.7) with a survival probability of 17.6% (95% CI: 10.9-28.4) at 60 months. Costs were concentrated in the first two years, with an average of BRL 72,849.13 per patient, and approximately BRL 18,489.44 monthly in those with metastatic disease. Conclusion: Real-world evidence can help identify knowledge gaps and drive access to innovations, reducing uncertainty and improving care. Treatment costs for patients diagnosed at metastatic stage demonstrate the importance of prevention by encouraging smoking cessation and screening for early detection in high-risk patients.